CHA News

CY 2025 Medicare Advantage, Part D Payment Changes Finalized

What’s happening: The Centers for Medicare & Medicaid Services (CMS) finalized changes to Medicare Advantage (MA) Part C and Part D payments for calendar year (CY) 2025.   

What else to know: Comments on the MA data request for information are due by May 29. The policies are effective Jan. 1, 2025.  

CMS estimates the finalized policies will increase MA plan revenues by an average of 3.7% from CY 2024 to CY 2025.  

CMS implements updates to the Part C risk adjustment model through a phased approach to reflect the International Classification of Diseases, tenth revision, condition categories, 2018 fee-for-service (FFS) diagnoses, and 2019 FFS expenditures, and provides technical updates to the methodology for CY 2025.  

The final notice includes updates to Part C and Part D star ratings to reflect the latest regulations and implements changes to the standard Part D drug benefit under the Inflation Reduction Act of 2022.   

Additional information is available in a fact sheet.